Triple S Slovenian Suicide Scrutinized
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1 Triple S Slovenian Suicide Scrutinized Saška Roškar National Institute of Public health, Ljubljana Koper, , Triple I
2 Itinerary 1. Features Suicide in Slovenia 3. Possible explanations 2. Time trends
3 1. Features of suicides in Slovenia Slovenia: Average suicide rate ( ) and avarage age of suicide victims Average all male female m/f ratio Suicide rate (per ) 26,63 43,00 11,66 3,96 Age* 51,83 (SD 17,50) 50,67 (SD 17,21) 55,80 (SD 17,95) / Big differences among different parts of Slovenia *p = 0,047
4 1. Features of suicides in Slovenia Regional differences in distribution of suicides in Slovenia SDR Obcine_93.shp
5 1. Features of suicides in Slovenia Years Regional differences in age 53,50 53,00 52,50 52,65 53,09 52,75 52,00 52,21 52,15 51,98 51,50 51,00 51,17 50,50 50,43 50,00 50,02 49,50 49,00 48,50 48,00 Celje Gorica Koper Kranj Ljubljana Maribor Murska Sobota Novomesto Ravne p = 0,023
6 1. Features of suicides in Slovenia Suicide methods all
7 1. Features of suicides in Slovenia Suicide methods male / female 1 1 MALE FEMALE x2 = 713,54; p < 0,000
8 1. Features of suicides in Slovenia years Suicide methods and age 70,00 60,00 50,00 48,68 53,27 58,82 51,07 51,48 55,61 52,36 49,29 56,49 40,00 40,48 42,09 30,00 20,00 10,00,00 solid or liquid substances gas hanging drowning gun shot explosives and fire sharp objects blunt objects jumping from height infront of moving object unspecified x2 = 353,55 p < 0,000
9 Itinerary 1. Features Suicide in Slovenia 3. Possible explanations 2. Time trends
10 2. Time trends in suicides in Slovenia Avarage suicide rate in Slovenia: vs Average suicide rate all male female m/f ratio * 31,00 48,5 14,4 3, ,63 43,00 11,66 3,96 Decrease in % 14,1 11,3 19,0 / *Marušič, 1999
11 2. Time trends in suicides in Slovenia Time trends in suicide rate in Slovenia: all male female : 411 suicides, low trend continues
12 2. Time trends in suicides in Slovenia Time trends in suicide rate in Slovenia: SDR(0-14) SDR(15-29) SDR(25-64) HFA MBD (WHO)
13 2. Time trends in suicides in Slovenia Warhol: They say that time changes things, but you actually have to change them yourself Austria Croatia Czech Republic Estonia Finland Hungary Latvia Lithuania Slovenia HFA MBD (WHO)
14 Itinerary 1. Features Suicide in Slovenia 3. Possible explanations 2. Time trends
15 3. Possible explanations
16 3. Possible explanations Pridemore & Snowden : J. Lonnqvist: improved better understanding of suicide symptoms and depression large- scale prevention campaign (20 years) Decrease in Finnland Alcohol policy only rise of social media such as Facebook, MySpace and Twitter What could have contributed to the decrease of suicide in Sovenia?
17 3. Possible explanations Core elements of suicide prevention (in Slovenia) from 2000 onwards Working together with professionals and gatekeepers Restriction of access to lethal means Suicide prevention (WHO/IASP) Enhancing prevention activites in local communities Working with the media (responsible reporting) What was done in Slovenia?
18 3. Possible explanations Core elements of suicide prevention (in Slovenia) from 2000 onwards Working together with professionals and gatekeepers - establishing of Slovenian Association for Suicide Prevention (SASP) in networking platform for professionals - seminars - better collaboration between the public health and the clinical sector joining the EAAD (European Alliance Against Depression) - public awarenes campaigns - workshop fo GP s on depression recogniton and treatment - self help groups to 2005 Slovenian Gotald study (CMJ, 2010) - workshops with GP s in 2 most affected regions (recognition and treatment of depression) - increase in AD perscription - tendency of decrease in Suicide in intervention regions , start of SOS campaigns: working together with different groups of professionals
19 3. Possible explanations Core elements of suicide prevention (in Slovenia) from 2000 onwards Working together with professionals and gatekeepers SOS campaigns: Spregovorimo O Samomoru med. (Let s talk about suicide among ) - youth - elderly - media LET S TALK ABOUT SUICIDE AMONG YOUTH ( ) Aims of the programme: To increase awareness and knowledge of school counsellors on suicidal behaviour among youth and to incresae their competence in dealing with suicidal students. Method: Workshops for all school counsellors in Slovenia
20 3. Possible explanations Core elements of suicide prevention (in Slovenia) from 2000 onwards Working together with professionals and gatekeepers LET S TALK ABOUT SUICIDE AMONG ELDERLY ( ) Aims of the programme: To increase competence of GP s in recognizing and treatment of depression and suicidal behaviour among elderly patients. Method: Workshop for all GP s in the region Ljubljana (pilot phase) Plans (2011): - Dissemination to GP s of other regions in Slovenia - Workshops for employers and users of Centres of daily activities for elderly people
21 3. Possible explanations Core elements of suicide prevention (in Slovenia) from 2000 onwards Enhancing prevention activites in local communities - Different activities in affected regions - lectures for broader public - TV and radio shows - establishing of self help groups (DAM ) - greater role of NGO s - destigmatization activities - Region Celje: - E for enthusiasm - regional group for suicide prevention - counseling office for users from the region (self financing!) - one of the most affected regions and at the same time region with biggest decrease in suicide in the last 10 years
22 3. Possible explanations Core elements of suicide prevention (in Slovenia) from 2000 onwards Working with the media (responsible reporting) Aims of the programme: To increase awareness of journalists/editors and other media representatives about responsible reporting about suicide and suicidal behaviour in media. Method: LET S TALK ABOUT SUICIDE AND THE MEDIA ( ) -Translation of IASP/WHO media guideliness - Focous group with journalists, feedback on the guideliness - Upgrading the media guideliness with comments from Journalists -Workshops for journalists/editors in Slovenia - media watch First encouraging results: - Reporting on suicide included in the journalists ethical kodeks
23 Network of 1 NIPH and 9 regional public health centres good dissemination enabeled * Ravne na Koroškem Maribor * * Murska Sobota Kranj * *Nova Gorica * Ljubljana (NIPH) * Celje Novo Mesto * *Koper
24 3. Possible explanations Core elements of suicide prevention (in Slovenia) from 2000 onwards NATIONAL PROGRAMME FOR MENTAL HEALTH Restriction of access to lethal means GOAL 1 GOAL 2 Mental health promotion Prevention of mental disorders and early detection of persons with MH problems GOAL 3 Combating stigma in MH disordres and social exclusion GOAL 4 Network of MH facilities in the public sector GOAL 5 Suicide prevention (primary prevention, secondary preventon, terciary prevention, recstriciton of access to lethal means, systematic gathering of suicide data) GOAL 6 Research and evalvation
25 3. Possible explanations Core elements of suicide prevention (in Slovenia) from 2000 onwards Working together with professionals and gatekeepers Restriction of access to lethal means Suicide prevention (WHO/IASP) Enhancing prevention activites in local communities Working with the media (responsible reporting)
26 Thank you for your attention Comments, questions
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